Unknown Individual – Clinical Psychologist, NPI 1184613697

Unknown Individual is a healthcare provider. based in Saint louis, Missouri. specializing in Clinical Psychologist. They hold a License No. 00071 (MO). The NPI Number for Unknown Individual is 1184613697

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1184613697
Phone
(314) 966-6638
Address
10000 WATSON RD
Deactivation Date
11 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 10000, Watson Road, Sunset Hills, Saint Louis County, Missouri, 63126, United States

    SOUTH BUILDING STE S

    SAINT LOUIS, MO 631261854

    Phone: (314) 966-6638

    Fax: (314) 965-2326

    Type: Location

  • 56, Orchard Lane, Windsor Springs, Kirkwood, Saint Louis County, Missouri, 63122, United States

    SAINT LOUIS, MO 631226945

    Phone: (314) 966-6638

    Fax: (314) 965-2326

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63126)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1184613697.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Saint Louis, Missouri as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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